Chest
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Randomized Controlled Trial Multicenter Study
Use of an Ultrathin Versus Thin Bronchoscope for Peripheral Pulmonary Lesions: A Randomized Trial.
When evaluating peripheral pulmonary lesions, a 3.0-mm ultrathin bronchoscope (UTB) with a 1.7-mm working channel is advantageous regarding good access to the peripheral airway, whereas a 4.0-mm thin bronchoscope provides a larger 2.0-mm working channel, which allows the use of various instruments including a guide sheath (GS), larger forceps, and an aspiration needle. This study compared multimodal bronchoscopy using a UTB and a thin bronchoscope with multiple sampling methods for the diagnosis of peripheral pulmonary lesions. ⋯ Multimodal bronchoscopy using a UTB afforded a higher diagnostic yield than that using a thin bronchoscope in the diagnosis of small peripheral pulmonary lesions.
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Randomized Controlled Trial Multicenter Study
Patient-level trajectories and outcomes after low-dose CT screening in the National Lung Screening Trial.
Shared decision-making is an essential element of low-dose CT (LDCT) screening for lung cancer. Understanding patient-level outcomes from the National Lung Screening Trial (NLST) is critical to effectively communicate risks and benefits of screening to patients. ⋯ We provide important patient-level data from the NLST that can be used to guide shared decision-making. The risk-to-benefit ratio of screening may vary significantly in some patients, such as those with COPD, in whom both risks and benefits of screening may be increased.
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Burnout syndrome is an increasingly common phenomenon that threatens our critical care workforce and the well-being of its members. Burnout syndrome can be conceived of as a workforce manifestation of chronic workload and workforce capacity imbalance. This study explores the role of workload management tools that can address workload as a complement to the resilience-based countermeasures that seek to increase worker capacity. ⋯ Our ICU workforce efficiency was calculated as the ratio of mandatory task time to scheduled time. Comparing this ratio vs a well-established industrial standard for equipment efficiency made us realize that our average workload seemed excessive and placed our staff at risk of burnout syndrome. It is difficult to conceive that our resilience-based countermeasures to prevent and treat burnout would not be more effective when combined with measures that reduce the time our staff members spend on mandatory ICU tasks.
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This study aimed to identify changing spatial and temporal trends of lung cancer mortality rates (LCMRs) among subpopulations in China (according to region, age, and sex). ⋯ Disparities in the spatial and temporal trends of LCMRs among subpopulations highlight the need for investigation into potential drivers, especially for the east, south, and southwest of China. These findings may help health authorities target interventions to those most in need to reduce the lung cancer burden in China.
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Chronic inflammatory diseases of the lung are often life-threatening and are a leading cause of morbidity in our communities. MicroRNAs (miRs) are now recognized to play critical roles in a wide range of cellular functions, including the regulation of immunologic processes, which are often dysregulated in chronic respiratory diseases. ⋯ Furthermore, experimental evidence suggests that pharmacologic inhibition of miR function or delivery of mimics may have therapeutic potential. The review also therefore discusses the potential utility and limitations of therapeutically targeting these molecules and their downstream pathways.